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What Causes Pain Around The Surrounding Tissue Of Stoma?

Posted on Mon, 22 Jun 2015

Question: I hav a BCIR and as a result I have an excess growth of tissue around my stoma and it is black and blue. The color of the stoma fluctuates as the pain In that area throughout the day. Sometimes the pain is am 8 or 9 in intensity and sometimes it goes down to a 3. one of the BCIR surgeons I spoke with says to get a nerve block. What do you suggest? Also, I would like to take care of the grapefruit-sized protrusion in my groin surrounding the stoma. Should I have the GI surgeon work on this, a plastic surgeon, or a neurosurgeon because it involves cutting into an are where there are a lot of blood vessels, lymphatic tissue, and nerves.

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Answered by Dr. Hari Charan Perigela (4 hours later)

Brief Answer:
Cause of the pain has to be known.

Detailed Answer:
Hi
Cause of pain has to be known in your case.As the pain is due to surrounding tissue of the stoma, I think that the stoma has not been properly created.The blood supply to the stomal part of the intestine might have decreased leading to colour change and pain.Excess growth of tissue could be Mesentry which carries blood supply to Intestine.
In my opinion, nerve block won't help.
You should consult a Surgical Gastroenterologist, not a Plastic or Neuro surgeon .
Grape fruit like protrusion in the groin could be Hernia.If you consult a Surgical Gastroenterologist, he will confirm this also.
Hope I answered your query. If you have any questions, I will clarify further.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Hari Charan Perigela (19 hours later)

One surgeon did diagnose this as a hernia, which I myself diagnosed 13 years ago. Other docs called it a weakness. Tissue surrounding is rock hard. not pliable. Would it benefit me to have a urologist look at it?

Answered by Dr. Hari Charan Perigela (4 hours later)

Brief Answer:
Hernia is related to surgeon .

Detailed Answer:
Hi
Hernia is related to surgeon only.
If surgeon is not available,you can consult a Urologist.
In my opinion, you should get a CT Scan abdomen which confirms the diagnosis of Hernia and then proceed.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Hari Charan Perigela (4 hours later)

I did get a CT scan by the last surgeon I saw and he did say it was a hernia. Would the stoma have to be disconnected if this is the case. He spoke about moving it to the left side from the current right side.

Answered by Dr. Hari Charan Perigela (17 minutes later)

Brief Answer:
No need to disconnect Stoma.

Detailed Answer:
Hi
Hernia can occur on both sides.Raised intra abdominal pressure can lead to hernia. As per your description, you are having hernia on both sides.
They can be operated in a single sitting.
There is no need to disconnect Stoma. Part of the bowel might be in the hernial sac causing swelling. During surgery bowel is replaced into the peritoneal cavity, hernia repair can be done by PROLENE mesh.
Nothing to worry.
Please consult your Surgeon, get it repaired and avoid complications.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Hari Charan Perigela (8 hours later)

Hernia is only on one side, the right side, left side is normal and pain free. How do I find the best surgeon to take care of the hernia without creating damage to the BCIR or creating more nerve damage. Not all surgeons are created equal.
Pain is caused by nerve compression, believed to be ileo-iguanal nerve location is Psoas muscle.

Answered by Dr. Hari Charan Perigela (30 minutes later)

Brief Answer:
Take help of a XXXXXXX surgeon.

Detailed Answer:
Hi
As Hernia surgery is done routinely by Surgeons,you can consult a XXXXXXX surgeon for the procedure.
In my opinion, pain is due to hernial content, rather than ilioinguinal nerve.when bowel comes into the hernial sac,there will be pain.
No Surgeon will damage the BCIR or Nerve.The nerve will be kept aside from the main dissection.Please do not worry.We just reduce the contents of the hernial sac and do Hernia repair.
Wish you good health.
Regards

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj